Contemporary psychiatry is becoming more biologically oriented in the attempt to elicit a biological rationale of mental diseases. Although mental disorders comprise mostly functional abnormalities, there is a substantial overlap between neurology and psychiatry in addressing cognitive disturbances. In schizophrenia, the presence of cognitive impairment prior to the onset of psychosis and early after its manifestation suggests that some neurocognitive abnormalities precede the onset of psychosis and may represent a trait marker. These cognitive alterations may arise from functional disconnectivity, as (...) no significant brain damage has been found. In this review we aim to revise A.R. Luria’s systematic approach used in the neuropsychological evaluation of cognitive functions, which was primarily applied in patients with neurological disorders and in the cognitive evaluation in schizophrenia and other related disorders. As proposed by Luria, cognitive processes, associated with higher cortical functions, may represent functional systems that are not localized in narrow, circumscribed areas of the brain, but occur among groups of concertedly working brain structures, each of which makes its own particular contribution to the organization of the functional system. Current developments in neuroscience provide evidence of functional connectivity in the brain. Therefore, Luria’s approach may serve as a frame of reference for the analysis and interpretation of cognitive functions in general and their abnormalities in schizophrenia in particular. Having said that, modern technology, as well as experimental evidence, may help us to understand the brain better and lead us towards creating a new classification of cognitive functions. In schizophrenia research, multidisciplinary approaches must be utilized to address specific cognitive alterations. The relationships among the components of cognitive functions derived from the functional connectivity of the brain may provide an insight into cognitive machinery. (shrink)
Our objective is to corroborate Merleau-Ponty's phenomenology of speech perception and intersubjectivity through an analysis of A. R. Luria's account of semantic aphasia. By emulating Merleau-Ponty's style of analysis in dealing with the work of a contemporary leader in the field of aphasiology, we are able to take up Merleau-Ponty's thought and test whether his conclusions are inevitable or whether they are based on outmoded problems of the psychology and psychopathology of his day. These reflections also enable us to (...) present arguments against both the assumptions of the natural attitude, as well as those of transcendental phenomenology, and so enable us to cast some light on the relation between existential phenomenology and empirical research. By contrasting aphasic and normal perception, we intend to show that ultimately even the aphasiologist is able to characterize aphasic perception only in terms of the aphasic's loss of an "openness" to meanings present in the uttered sounds. We argue that this notion of openness, like that of Merleau-Ponty's notion of "perceptual faith, " requires the reduction but also points to the impossibility of a complete reduction. (shrink)
This paper argues that cognitive psychology's practice of explaining mental processes in terms which avoid invoking phenomenology, and the person-level self-conception with which it is associated in common sense psychology, leads to a hybrid Cartesian dualism. Because phenomenology is considered to be fundamentally irrelevant in any scientific explanation of the mind, the person-level is regarded as scientifically invisible: it is a ghost-like housing for sub-personal computational cognition. The problem of explaining how the sub-personal and sub-phenomenological machinery of mind is related (...) to person-level experience is as troublesome for cognitive psychology as the problem Descartes faced in explaining how the ghost (the non-corporeal mind) is related to the machine (the material body).This paper outlines the historical roots of cognitive dualism, showing how it has come to recapitulate a number of puzzling conceptual dichotomies that have hindered scientific and philosophical psychology since Kantian constructivism. It then defends the view that cognitive psychology's commitment to the sub-personal explanatory level leads to exaggerated deflationary claims about the explanatory significance of phenomenology, and the personlevel framework. It is argued that phenomenological description must function as a constraint upon, and guide for, theory formation in cognitive psychology (as illustrated in the work of the cognitive neuro-psychologist A.R. Luria). Phenomenology must be brought into a kind of reflective equilibrium with the cognitive and neuro-sciences. (shrink)
When this work was first published in 1960, it immediately filled a void in Kantian scholarship. It was the first study entirely devoted to Kant's _Critique of Practical Reason_ and by far the most substantial commentary on it ever written. This landmark in Western philosophical literature remains an indispensable aid to a complete understanding of Kant's philosophy for students and scholars alike. This _Critique_ is the only writing in which Kant weaves his thoughts on practical reason into a unified argument. (...) Lewis White Beck offers a classic examination of this argument and expertly places it in the context of Kant's philosophy and of the moral philosophy of the eighteenth century. (shrink)
Bradley is often described as an Anglo-Hegelian, and hence it is assumed that his doctrines derive from Hegel. It is true that his first two works ‘The Presuppositions of Critical History’ and Ethical Studies are heavily influenced by Hegel. The Principles of Logic is much less so: it certainly contains a number of both laudatory and critical references to Hegel, but the whole design of the book is completely unrelated to his treatment of logic. Appearance and Reality seems to me (...) not to be Hegelian at all. The interesting logical discussions occur in the Principles, and it is here that we can find points of comparison between Bradley and Frege and Russell. This is in part because all three were agreed that it was impossible to account for logic by reference to psychology. Bradley's doctrine of internal relations first emerges in this context, though it is given a more metaphysical interpretation in the subsequent Appearance and Reality. However, most who have talked of internal relations have taken their view from the latter work, and have found the doctrine either confused or silly. This quotation from Appearance and Reality seems to bring out all that is objectionable in the view: And if you could have a perfect relational knowledge of the world, you could go on from the nature of red-hairedness to these other characters which qualify it, and you could from the nature of red-hairedness reconstruct all the red-haired men. In such perfect knowledge you could start internally from any one character in the Universe, and you could from that pass to the rest…For example, a red-haired man who knew himself utterly would and must, starting from within, go on to know everyone else who had red hair, and he would not know himself until he knew them. But, as things are, he does not know how or why he himself has red hair, nor how and why a different man is also the same in that point, and therefore, because he does not know the ground, the how and why, of his relation to other men, it remains for him relatively external, contingent, and fortuitous. But there is really no mere externality except in his ignorance. (shrink)
New arguments against Bayesian regularity and an otherwise plausible domination principle are offered on the basis of rotational symmetry. The arguments against Bayesian regularity work in very general settings.
_The first part called the Preamble tackles: (a) the issues of silence and speech, and life and disease; (b) whether we need to know some or all of the truth, and how are exact science and philosophical reason related; (c) the phenomenon of Why, How, and What; (d) how are mind and brain related; (e) what is robust eclecticism, empirical/scientific enquiry, replicability/refutability, and the role of diagnosis and medical model in psychiatry; (f) bioethics and the four principles of beneficence, non-malfeasance, (...) autonomy, and justice; (g) the four concepts of disease, illness, sickness, and disorder; how confusion is confounded by these concepts but clarity is imperative if we want to make sense out of them; and how psychiatry is an interim medical discipline. The second part called The Issues deals with: (a) the concepts of nature and nurture; the biological and the psychosocial; and psychiatric disease and brain pathophysiology; (b) biology, Freud and the reinvention of psychiatry; (c) critics of psychiatry, mind-body problem and paradigm shifts in psychiatry; (d) the biological, the psychoanalytic, the psychosocial and the cognitive; (e) the issues of clarity, reductionism, and integration; (f) what are the fool-proof criteria, which are false leads, and what is the need for questioning assumptions in psychiatry. The third part is called Psychiatric Disorder, Psychiatric Ethics, and Psychiatry Connected Disciplines. It includes topics like (a) psychiatric disorder, mental health, and mental phenomena; (b) issues in psychiatric ethics; (c) social psychiatry, liaison psychiatry, psychosomatic medicine, forensic psychiatry, and neuropsychiatry. The fourth part is called Antipsychiatry, Blunting Creativity, etc. It includes topics like (a) antipsychiatry revisited; (b) basic arguments of antipsychiatry, Szasz, etc.; (c) psychiatric classification and value judgment; (d) conformity, labeling, and blunting creativity. The fifth part is called The Role of Philosophy, Religion, and Spirituality in Psychiatry. It includes topics like (a) relevance of philosophy to psychiatry; (b) psychiatry, religion, spirituality, and culture; (c) ancient Indian concepts and contemporary psychiatry; (d) Indian holism and Western reductionism; (e) science, humanism, and the nomothetic-idiographic orientation. The last part, called Final Goal, talks of the need for a grand unified theory. The whole discussion is put in the form of refutable points._. (shrink)
The catch 22 situation in psychiatry is that for precise diagnostic categories/criteria, we need precise investigative tests, and for precise investigative tests, we need precise diagnostic criteria/categories; and precision in both diagnostics and investigative tests is nonexistent at present. The effort to establish clarity often results in a fresh maze of evidence. In finding the way forward, it is tempting to abandon the scientific method, but that is not possible, since we deal with real human psychopathology, not just concepts to (...) speculate over. Search for clear-cut definitions/diagnostic criteria in psychiatry must be relentless. There is a greater need to be ruthless and blunt in this, rather than being accommodative of diverse opinions. Investigative tests - psychological, serum, CSF, or neuroimaging - are only corroborative at present; they need to become definitive. Medicalisation appears most prominent in psychiatry; so, diagnostic proliferation and fuzziness appear inevitable. And yet, the established diagnostic entities need to forward greater and conclusive precision. Also, the need for clarity and precision must outweigh pandering to and mollifying diverse interests, moreso in the upcoming revision of diagnostic manuals. This is specially because the DSM-5, being an Association manual, may need to accommodate powerful member lobbies; and ICD-11 may similarly need to cater to diverse country lobbies. Finding precise biological correlates of psychiatric phenomena, whether through neuroimaging, molecular neurobiology and/or neurogenomics, is the right way forward. It is in the 1.5-kg structure in the cranium that all secrets of psychiatric conditions lie. Social forces, behavioural modification, psychosocial restructuring, study of intrapsychic processes, and philosophical insights are not to be discounted, but they are supplementary to the primary goal - studying and deciphering those brain processes that result in psychiatric malfunction. Experimental breakthroughs, both in psychiatric aetiology and therapeutics, will come mainly from biology and its adjunct, psychopharmacology; while supplementary and complementary breakthroughs will come from the psychosocial, cognitive and behavioural approaches; the support base will come from phenomenology, epidemiology, nosology and diagnostics; while insights and leads can hopefully come from many fields, especially the psychosocial, the behavioural, the cognitive and the philosophical. Major energies must now be marshalled towards finding biomarkers and deciphering the precise phenotype-genotype-endophenotype axis of psychiatric disorders. Energies also need to be focussed on unravelling those critical processes in the brain that tip the scale towards psychiatric disorders. At how those critical processes are set into motion by forces de novo, in utero, in the genes and their expression, by the environment's psychopathological social forces - stress, peer pressure, poverty, deprivation, alienation, malnutrition, discrimination of various types (caste, gender, race, etc.), mass conflicts (war, terror attacks, etc.), disasters (natural and man-made), religious/ideological fascism - or social institutions like marriage, family, work place, political governance, etc. Ultimately, we must decipher how the brain goes into malfunction when such varied forces impinge on it, which precise cortical areas and neuronal cellular and molecular processes are involved in such malfunction and its manifestation, as also which of these are involved when malfunction ceases and health is restored, and the psychosocial processes and institutions which aid such health restoration, as also those which promote well-being and help in primary prevention. Emphasis on the brain and its intimate neurological and molecular mechanisms will not impinge on, or nullify, importance of the 'mind,' wherein subtle and gross brain functions in the form of behaviour, thought and emotions in all their ramifications will continue to be the focus of psychological, cognitive, sociological, psychopharmacological, behavioural and philosophical research. Progress in brain research must move in tandem with progress in 'mind' research. (shrink)
This paper examines the perceived ethical values of Malaysian managers. It is based on the opinions of 15 hypothetical ethical/unethical business situations from the 81 managers who agreed to participate in the survey. The findings of this study showed that these Malaysian managers have high ethical values. However 53% of the respondents believed that the ethical standards of today are lower than that of 15 years ago. Apparently, this is related to the existence of many unethical business practices prevalent in (...) the modern business world. The behavior of one's immediate superior is the most important factor in influencing managers to commit unethical practices. The results also indicate only a slight variation among the managers in terms of perceived ethical values by virtue of job position, job specialization, type of business activity or the size of the business organization. (shrink)
Truthmaker monism is the view that the one and only truthmaker is the world. Despite its unpopularity, this view has recently received an admirable defence by Schaffer :307–324, 2010b). Its main defect, I argue, is that it omits partial truthmakers. If we omit partial truthmakers, we lose the intimate connection between a truth and its truthmaker. I further argue that the notion of a minimal truthmaker should be the key notion that plays the role of constraining ontology and that truthmaker (...) monism is not necessary for an appropriate solution to the problem of finding truthmakers for negative truths. I conclude that we should reject truthmaker monism once and for all. (shrink)
As a patient approaches death, family members often are asked about their loved one’s preferences regarding treatment at the end of life. Advance care directives may provide information for families and surrogate decision makers; however, less than one-third of Americans have completed such documents. As the U.S. population continues to age, many surrogate decision makers likely will rely on other means to discern or interpret a loved one’s preferences. While many surrogates indicate that they have some knowledge of their loved (...) one’s preferences, how surrogates obtain such knowledge is not well understood. Additionally, although research indicates that the emotional burden of end-of-life decision making is diminished when surrogates have knowledge that a loved one’s preferences are honored, it remains unclear how surrogates come to know these preferences were carried out. The current study examined the ways that next of kin knew veterans’ end-of-life preferences, and their ways of knowing whether those preferences were honored in Veteran Affairs Medical Center inpatient settings. (shrink)
Suicide is amongst the top ten causes of death for all age groups in most countries of the world. It is the second most important cause of death in the younger age group (15-19 yrs.) , second only to vehicular accidents. Attempted suicides are ten times the successful suicide figures, and 1-2% attempted suicides become successful suicides every year. Male sex, widowhood, single or divorced marital status, addiction to alcohol ordrugs, concomitant chronic physical or mental illness, past suicidal attempt, adverse (...) life events, staying in lodging homes or staying alone, or in areas with a changing population, all these conditions predispose people to suicides. The key factor probably is social isolation. An important WHO Study established that out of a total of 6003 suicides, 98% had a psychiatric disorder. Hence mental health professionals have an important role to play in the prevention and management of suicide. Moreover, social disintegration also increases suicides, as was witnessed in the Baltic States following collapse of the Soviet Union. Hence, reducing social isolation, preventing social disintegration and treating mental disorders is the three pronged attack that must be the crux of any public health programme to reduce/prevent suicide. This requires an integrated effort on the part of mental health professionals (including crisis intervention and medication/psychotherapy), governmental measures to tackle poverty and unemployment, and social attempts to reorient value systems and prevent sudden disintegration of norms and mores. Suicide prevention and control is thus a movement which involves the state, professionals, NGOs, volunteers and an enlightened public. Further, the Global Burden of Diseases Study has projected a rise of more than 50% in mental disorders by the year 2020 (from 9.7% in 1990to 15% in 2020). And one third of this rise will be due to Major Depression. One of the prominent causes of preventable mortality is suicidal attempts made by patients of Major Depression. Therefore facilities to tackle this condition need to be set up globally on a warfooting by governments, NGOs and health care delivery systems, if morbidity and mortality of the world population has to be seriously controlled . The need, first of all, is to identify suicide prevention as public health policy, just as we think in terms of Malaria or Polio eradication, or have achieved smallpox eradication. (shrink)
